Section 00


Duality® is a decentralized application development platform with the potential to change how health systems are designed, built, and interact with one another. At its core, Duality creates a data infrastructure and interoperability framework to help support the foundation of information exchange across all health sector boundaries including physical infrastructure (networks), services, and applications. Designed based on accepted and emerging industry standards including HIPAA, HITECH, GDPR, 21st Century Cures Act, CMS-9115-F, FHIR, and OAuth 2, Duality’s goal is to simplify the barriers of healthcare innovation by developing an intuitive data management platform that's highly secure, globally scalable, and provides developers with new and sustainable business models for their applications.

Section 01


The global healthcare industry is in the early stage of a prolonged period of change and transformation catalyzed by several significant events. From policies to regulations, and across the healthcare landscape, influencers are successfully driving agendas like value-based care, a more competitive market environment, and increased transparency - all aimed at raising the standards on health outcomes and system efficiencies. Emerging with this transition is a new set of architecture paradigms founded with the values of patient-centered data ownership and exchange.

Current health data management systems force patients into a trusted relationship with third parties that prevent access to complete health information. However, with new regulations like the 21st Century Cures Act, the ability to securely manage and share data at scale is a critical requirement for any modern healthcare system.

At Duality, we believe that good data starts with accurate patient identification. In order to successfully exchange health information we have to 1) protect the patients’ data and 2) have the ability to successfully search each individual’s record in disparate locations and know that it refers to the correct person.

But how do we ensure both data privacy and data utility?

This is the fundamental question in today’s health data ecosystem.

Section 02

Why Duality?

Blockchain technology offers the healthcare industry a decentralized trust layer that removes human error and increases the security, privacy, and interoperability of health data. Grounded in math and cryptography, blockchain creates a quantifiable approach to data privacy that eliminates numerous barriers preventing healthcare innovation.

While blockchain technology shows enormous potential, alone, it is not enough to solve the complex problems surrounding health data.

To address these industry specific needs, the Duality platform has integrated several key technologies and healthcare specific APIs including AI-powered biometric identity authentication, hashed FHIR profiles, machine learning data matching algorithms, smart contracts, decentralized computing, and an industry first peer-to-peer (P2P) file sharing protocol using WebRTC initiated by blockchain signaling. When combined, these technologies can be used to support global health data interoperability without compromising privacy or security.

Duality standardizes, on behalf of all its users, the largest compliance and technical barriers to healthcare innovation: accurate identification and credentialing (patient, provider, and organization), PII/PHI privacy, and secure, real-time data exchange. Duality helps simplify the barriers of health care innovation and hopes to create a community of passionate developers who can easily turn ideas into solutions.

Duality will be the world’s first decentralized, community-driven healthcare development platform with an intuitive design experience, large scale capacity, and the ability for developers to create new and sustainable business models for their applications.

Section 03

Design Principles

The foundation for both the design and development of the Duality platform are guided by a strict set of principles. These principles reflect the problems inherent in both centralized and decentralized health systems today.

  • Compliance: The Duality platform should meet and/or exceed global health data standards including HIPAA, HITECH, and GDPR.
  • Security: Health data is highly sensitive and should be protected by a robust security infrastructure that ensures data is not compromised.
  • Interoperability: Data should remain private yet be usable between disparate systems.
  • Simplicity: The design and use should seamlessly integrate with existing electronic health records for quick deployment into existing workflows.
  • Scalability: The platform should scale with no upper limits in order to support enterprise grade, globally available applications.

Section 04

Platform Design

Duality is a decentralized data infrastructure and interoperability framework that allows health IT developers to accurately and securely identify, manage, track, and link global health data in real-time. The infrastructure behind the platform is secured by a potentially infinite number of decentralized nodes run by individuals and organizations from around the world that contribute a portion of their CPU and hard drive space to the platform. This creates a network with always on availability and without a single point of failure.

Duality includes both a public permissionless and private permissioned blockchain infrastructure for deploying and running decentralized applications. This hybrid design allows developers to access public data resources, like a trusted provider directory, while at the same time manage private data with secure access control. Developers write smart contract applications and deploy them on the platform through a process that feels very similar to how applications are deployed to existing centralized clouds. When end-users interact with the application they will likely not even realize it’s a blockchain powered application and, with proper development, will function seamlessly with web and/or mobile interfaces.

Duality is underpinned by the technology of the Dynamic public blockchain. Dynamic functions as an open, highly redundant and available API framework used to audit, verify, and request access to sidechains. Proof-of-work and proof-of-stake consensus algorithms are used to reach agreement on transactions and maintain trust between nodes rather than a central authority driving change and administration. This helps reduce resourcing requirements, directory maintenance costs, and eliminates the need to employ trusted third parties for hosting, administering and managing data.
Sidechains allow granular access control, industry best security, high availability, robust accountability with immutable audits, and smart contracts to enforce critical business logic. Sidechains are extensions of the mainchain that increase scalability by offloading tasks. Duality sidechains can be public or private depending on the developers desired application. Sidechains use accounts and/or certificates to authorize who is allowed to access their private blockchain. Sidechains can have different consensus rules and sovereignty to meet the needs required by the hosted application. By offloading (sharding) computation and transactions to sidechains, the Duality platform can achieve higher throughput and indefinite scalability. Sidechains also remove bloat from the mainchain and can make applications that need large scale transactions faster and private. Our sidechains will also have the ability to run distributed SQL and NoSQL databases with account and/or certificate based access control and authentication. Since healthcare data must remain confidential and secure, a trusted permissioned blockchain layer is required. graph

Section 05

Development Suite

The Duality platform is designed to democratize healthcare innovation. To achieve this we’re releasing a set of tools and reference implementations to facilitate development, deployment, and adoption. These tools include:

  • Smart Contracts: The Duality platform will have an embedded Ethereum Virtual Machine (EVM) that can run ERC20 smart contracts to provide developers with a familiar development and deployment framework. These smart contracts will support custom application development and asset creation that enhance the overall use of Duality.
  • Other Tokens: Application developers may create their own smart contract based tokens with their own set of rules and functions as required by the unique application. This is very similar to how new tokens and applications are created using the Ethereum protocol.
  • Unique Digital Assets: Digital assets can be created to represent real-world assets and asset ownership. These assets can be stored, moved and tracked using the platform.
  • Cloud Infrastructure Orchestration: A management tool to control major cloud infrastructure provider keys within your wallet. It is designed to automate infrastructure orchestration tasks and quickly deploy cloud resources for your application.
  • Application Sandbox Environments: Testing environments with mock data and connections to FHIR resources and related services.
  • Software Development Kits: Software development kits to provide instructions and use case examples in multiple languages demonstrating the utility of all APIs, smart contracts, sandboxes and private sidechains.
  • Dynamic Explorer: To aid with both debugging of contracts and the understanding of network performance. The explorer presents information from the blockchain in an easily digestible web-based format.
  • Dynamic Controller Wallet: A wallet is a basic place for developers to store the assets they need to use the network. The Dynamic controller wallet is intended to be a seamless development console with built-in functionality to easily enable APIs, smart contracts and sidechains.
  • Thin Blockchain Wallets: Thin blockchain wallets are essential for blockchain applications and the ability to quickly sign transactions that are needed within an application. The wallets will be available for major mobile platforms and as a browser extension. A good example of this technology in practice is MetaMask used by ERC-20 applications.
  • API Library: Duality will have an ever evolving suite of APIs for developers to quickly deploy and integrate into their applications. APIs are discussed further in the technology overview section.
  • Platform Application Store: A central marketplace for users to browse available solutions and for developers to leverage the Duality global network.

Section 06

Technology Overview

The following section highlights the various technologies of the Duality platform including its underlying blockchain technology.

Accounts and Linking:

Duality’s innovative Blockchain Directory Access Protocol (BDAP) is a component of the platform that provides a decentralized mechanism for resource hierarchy management, data sharing, and data storage. BDAP adds a layer of resource hierarchy comparable to Lightweight Directory Access Protocol (LDAP). It provides a distributed database and account linking to the Dynamic blockchain and its sidechains. Unlike other protocols in existence today, this makes it possible to develop core information systems from a hybrid public-private blockchain. The hybrid design allows both anonymous and identified (permissionless and permissioned) nodes to connect and share data privately and securely without a third-party intermediary.

BDAP accomplishes this by managing user accounts, group accounts, links between objects, audits, certificates, sidechain parameters, checkpoints, and identity records on the Dynamic blockchain. BDAP manages accounts similar to LDAP, but also stores linkages between accounts. BDAP’s resource naming models the internet, uses fully qualified domain names (FQDNs), and will automatically create a unique object identifier (OID) for every object on the blockchain. BDAP is currently registered with ANSI and has its own root level OID which it can use to assign child OIDs.

BDAP will facilitate the creation of decentralized applications. Examples of how BDAP is utilized includes:

  • Create accounts for healthcare provider organizations and link them with other organizations on the blockchain.
  • Fine grained access control and authentication.
  • Deploy on sidechains to support private data transactions.
  • Link BDAP accounts to create another set of public keys that are used to connect disparate organizations registered on the Dynamic public blockchain.

For additional insight we refer the reader to BDAP’s stand-alone whitepaper.

Miners and Transaction Validation:

The Dynamic blockchain makes use of a special two-layered approach to securing the network. The first layer is regular full-node instances of Dynamic called Proof-of-Work Miners. Like traditional blockchains such as Bitcoin or Ethereum, Miners play a crucial part in supporting the integrity of the Dynamic blockchain. This network of computers records, audits, and verifies transactions on the blockchain in a public list that can be accessed by anyone. Another advantage of proof-of-work mining is that it creates a random hash at every block which can be used by applications as a global random number generator.

The second layer used to secure the network is Proof-of Stake Miners. In addition to proof-of-work, proof-of-stake increases scalability, lowers maintenance costs, and keeps the chain running at a fast, predictable pace.


Dynodes are collateralized full-nodes running the Dynamic blockchain. Dynodes require the operator to hold 1,000 DYN as collateral as well as dedicate their public internet address, CPU, memory, storage and bandwidth to the network. Each Dynode is rewarded for its service with DYN tokens as an incentive for supporting chain integrity and services. Dynodes help to lay the groundwork for blockchain services and are needed to propagate transactions faster and perform services like decentralized network routing and storage for BDAP. Dynodes provide the blockchain users and applications with an extremely fast global network relay system that is used to send instant messages for decentralized applications. Dynodes also currently host a Distributed Hash Table (DHT) and will be further developed to support hosting distributed document, SQL, and NoSQL databases. Dynodes also currently support additional auxiliary services like PrivateSend and InstantSend. PrivateSend is intended to protect user privacy when using tokens to pay for database, network and/or storage services. PrivateSend uses the CoinJoin method to anonymize assets. InstantSend is used when immediate blockchain transaction settlement is required. InstantSend can finalize a transaction within seconds, instead of waiting for the next block which can take minutes.

KYC Nodes:

In order to ensure compliance with data sharing standards, both in the US and internationally, participants on the platform that plan to share and utilize common healthcare data sets in their applications, even if anonymized, must be credentialed and verified. In order to do this in a semi-autonomous fashion Duality’s network will have a tier of five KYC Nodes per geographic region.

KYC nodes, after a successful KYC accreditation, are responsible for issuing certificates to a Requestor, defined as the individual or organization that is requesting access to a protected data set, sidechain, or communication channel. The KYC nodes are ultimately responsible for ensuring that the network has a clean user base of verified locations, providers, and developers. It is anticipated that major healthcare oversight and innovation organizations will assume the roles of the KYC nodes as the network matures.

To initiate the KYC request, the Requestor will use Duality’s KYC interface which packages all of the requested information required for the KYC node to complete its verifications. Once the packet of information has passed through the initial screening performed by Duality’s KYC interface, which uses an artificial intelligence to check for completeness of the data packet, the five KYC nodes will be placed in a verification queue using a random number generator from the PoW mining hashes. The first KYC node is responsible for the full verification process. The second node is responsible for performing an audit of the first KYC’s work to ensure the verification work was done thoroughly and accurately. The remaining nodes serve as backups in the case the first node does not pick up the data packet for processing in a timely fashion, currently earmarked at 24 hours. If the first KYC node does not pick up the data packet for processing within the 24 hour time frame, the second node will assume the role of the primary credentialing node with the third node assuming the role of the auditor. This process would continue until the packet is picked up and the credentialing process is started.

To incentivize participation as a KYC node a payment will be made in DYN from the Requestor. To automate the payment process DYN will be wrapped in a smart contract that settles based on proof of service. Proof of service is defined as a result issued to the smart contract from the KYC node as either pass or fail. The payment will be split 80% to the primary validation KYC node and 20% to the audit node.

Distributed Hash Table:

A distributed hash table (DHT) is a class of decentralized distributed storage systems which provides lookups similar to a hash table. Key/value pairs are stored in a DHT, and any participating node can efficiently retrieve the value associated with a given key. The responsibility for maintaining the mapping from keys to values is distributed among BDAP nodes in such a way that a change in the set of participants causes a minimal amount of disruption. This allows a DHT to scale to extremely large numbers of nodes while being able to handle continual node arrivals, departures, and failures at the same time. BDAP leverages the Kademlia DHT which provides robust resistance to attacks like denial-of-service attack via its ability to recover itself. Applications can use the DHT to store encrypted application cache needed by the BDAP account running the software at runtime. Applications built on the Duality platform can also use the DHT to store encrypted account linkage cache. For example, a single sign on application can use the DHT to store the provider’s credentials. Unlike blockchain storage, DHT cache can be deleted, is mutable and doesn’t need a transaction to commit. A thin client can be used to bypass the blockchain and access data in the DHT directly with BDAP account private keys.


Initially, Duality will support MongoDB for its document database functionality. YugaByte will handle more complex database applications and supports PostgreSQL and Cassandra wire formats, providing the ability to port existing applications written for those popular data management systems. BDAP authentication will be required to authenticate and authorize access to those data stores.

Attestations and Certificates:

Certificates contain a public key and an identity (a hostname, or an organization, or an individual), and are signed by a trusted certificate authority. Once validated, someone holding that certificate can rely on the public key it contains to establish secure communications with another party, or validate documents digitally signed by the corresponding private key. Certificates are used to attest to and authorize what accounts belong to valid credentialed healthcare providers so other participants can establish trust relationships. The certificates use an industry accepted X.509 standard.

Provenance and Audits:

Duality relies on the Dynamic public blockchain for its powerful auditing capabilities. Since blockchain records are immutable over time and replicated by the public, they make the perfect timestamp and proof of existence system that applications can use to audit system events such as patient enrollment and registration.

End-to-End Encryption:

Duality has developed Very Good Privacy (VGP), an end-to-end group cryptosystem library, to provide an encryption layer which goes well beyond current Pretty Good Privacy (PGP) encryption programs to protect privacy and security. VGP is modeled after PGP cryptosystem by using public key cryptography, symmetrical encryption, Diffie-Hellman key exchange and hashing for pubkey fingerprinting. For additional insight we refer the reader to VGP’s stand-alone whitepaper [ref].

Ephemeral Token System:

An innovative ephemeral token system is used to enable just-in-time access to sensitive data so it can remain in the control of the original custodian within their systems instead of duplicate copies housed in a central repository. The temporary access token expires within minutes so that the sensitive data exchange mechanisms do not remain open to exploitation. The ephemeral access token is verified by the identity service API, discussed below, and creates an audit that records when, where, and who accessed the data.

Fluid Protocol:

Duality has developed Fluid Protocol to handle self-regulation, arbitration features, and voluntary governance without going through contentious hard forking scenarios. The Fluid Protocol is a mechanism to change the consensus rules of the Dynamic blockchain, to enforce self-regulation, change the reward amounts for Miners and Dynode operators, and respond to arbitrations (account revocation, etc). For additional insight we refer the reader to the Fluid Protocol whitepaper [ref].


Duality will have oracle technology built into its platform. The oracle is a way for the blockchain or its various smart contracts to interact with external data points such as exchange prices, other blockchain data sets, database sets, etc. The oracle technology builds the path between off-chain and on chain events and can be easily deployed and utilized for application development. The immediate use case of the oracle technology is within the Arbitrage Smart Contract.

In addition to the technology discussed above, the Duality platform will launch with a set of prebuilt APIs designed to simplify the integration of our identity and data sharing protocols. When combined, these APIs provide the basis for accurate patient matching and data interoperability in a way that is secure and scalable.

Identity Services API:

Duality’s identity service API, dubbed NoID, uses hashed biometrics (biohashing) and hashed demographics to facilitate highly accurate, cross organizational data matching without exposing Protected Health Information (PHI) or Personally Identifiable Information (PII) to a central authority. The hashed biometrics and demographics create tokenized identity profiles and are hosted by private permissioned sidechains. This architecture reduces the security risks usually associated with high scale biometric identity system deployments and creates an identification protocol that is fully HIPPA compliant. This API package will include an enrollment web browser plug-in that provides bimodal biometric authentications, data anonymization, artificial intelligence, FHIR messaging, and biohashing. This is a key API that sets up the Duality platform for interoperability in a way that is accurate, secure and scalable.


NoID implements cross organizational patient matching by using a novel biohashing identity service built on top of Hyperledger Fabric (HLF). Before patient data is sent to the identity service, it is hashed to remain anonymous yet maintains the ability to accurately match. The identity service uses proximity queries for the biohashes and deterministic or exact match queries to confirm the demographics is similar for a particular biometric profile. When a match is found as a result of a participating organization query, a relationship is formed with the patient so that it can return location pointers on where a particular patient’s data resides. After a successful patient identity match, the service returns a list of record locations with an ephemeral access token for each location so it can start the P2P data fetching process.

For more information, please see the technical white paper [ref].

File and Data Sharing API:

WebBridge is Duality’s P2P data sharing protocol. This network has the innovative ability to connect through firewalls and NATs using a transient WebRTC connection with signaling initiated by the Dynamic public blockchain. WebRTC uses the latest TLS protocol with AES encryption and eliminates the need for a central host and site to site VPN connections. vWebBridge is open source, has a highly-developed user interface plug-in, and will be used within the Duality platform as a means to securely share sensitive data. The vWebBridge is the key API that sets up the organizational connectivity for all applications and stakeholders on the Duality platform.

Medical Terminology Engine:

Duality will have a medical Terminology RESTful API that manages medical semantics, vocabulary, internal codes, and nomenclature curated by machine learning and rewarded experts. This is a key API that standardizes data sets among disparate sources to ensure it is digestible and meaningful.

Clinical Data Aggregation Engine:

Responsible for standardizing EMR and other healthcare data when aggregating from multiple sources. A sophisticated AI that presents relevant clinical data for the clinical support.

Patient Portal:

Patient wallet used to control data access by issuing access tokens to third parties like health insurance providers, accountable care organizations and clinical research networks. Allows the patient to view audits - who, when, and where your data was viewed.

Section 07


The economic model for digital tokens on a decentralized platform is one of the most critical components of adoption and network growth. This is especially true for the dual token system deployed by Duality which uses a public blockchain to power solutions within a highly nuanced and heavily regulated healthcare industry. The following section will discuss the tokenomics for both DYN and DGA.

DYN, the native token of the Dynamic blockchain, is publicly available and has been in use since 2016. DGA, which stands for Duality Global Asset is a new asset that will be launched in 2022.

DYN has a circulating supply of approximately 15.1M with annual inflation of approximately 530k new tokens per year. DYN is used as the DApp fuel system for the application layer, offers a guaranteed maximum price of $10, and is burned when used.

Baseline Emission Rates
Type Rewards per Block Block per Year Annual Inflation
PoW Miner 1 262,800 262,800
PoS Miner 0.01 262,800 2,628
Dynode 1 262,800 262,800
Total 528,228

The economic goals of DYN are to ensure there is enough fuel supply for DApps, a predictable cost, and that there is proper incentive for Validators to secure the network. To achieve this, Duality has created an Emission Algorithm to reward Validators and an Arbitrage Smart Contract to cap the fuel price for developers.

Emission Algorithm: The Dynamic blockchain automatically adjusts DYN emission rate through use of a novel Emission Algorithm (EA). The EA dynamically changes the Validator rewards using the burn rate from the previous 5,040 blocks (approximately every 7 days). This is different from existing protocols such as Bitcoin where the block rewards decrease over time and Validators rely on price appreciation. In the Dynamic ecosystem, Validators rely on increased rewards to offset the capped price of DYN.

The Arbitrage Smart Contract (ASC): The ASC is an autonomous exchange built on the Dynamic blockchain using Smart Contract, Oracle, and Fluid Protocol technologies. The ASC is designed to allow arbitrage opportunities when the price of DYN exceeds $10. Using oracle technology, the ASC has the ability to determine the real time price of DGA and mint, on demand, the equivalent amount of DYN at a $10 exchange rate. Having the ASC as a secondary market to exchange DYN ensures the market value of DYN can always be arbitraged back down to $10. This mechanism provides predictable infrastructure costs for developers.


Once the DGA tokens are sent to the ASC they are stored until a release is triggered from the staking pools on the platform. Offering staking pools on the platform provides ongoing liquidity for DGA by guaranteeing the total supply of DGA does not get locked up permanently in the ASC.

The second token on Duality’s platform, DGA, is a smart contract based token that has a fixed supply of 750M, is subject to tiered lock-up periods, and has no token emissions. DGA’s primary role in the ecosystem is to absorb the price volatility of DYN. The breakdown of the genesis supply and its release schedule is shown below:

graph graph

DGA can be stored in interest bearing wallets that are subject to yield driven lock-up periods. This process is defined as staking. Interest is paid out to the holder as a reward for supporting liquidity on the platform and is distributed at the end of each lock-up period. Staked DGA tokens are not contractually bound to the lock-up periods, but if removed early, will forfeit the right for any interest payment.

To support the interest payments at platform launch, the ASC will be funded with 6.70% of DGA’s genesis supply. As the platform matures and DYN is arbitraged, the ASC will be continually replenished with DGA.

With adequate supply of DGA in the ASC, interest will be paid out targeting the following staking rates:

DGA Staking Rates
Staking Pool Min Stake Max Stake Interest Rate
30 Days 100 10,000 0.50%
60 Days 200 20,000 1.80%
180 Days 400 40,000 3.90%
365 Days 800 80,000 7.60%

When there is not a sufficient supply of DGA available in the ASC to pay the baseline rates, interest will be paid out pro-ratably based on the number of DGA tokens locked up in each staking pool. The estimated interest rate for each staking pool will be publicly available on the block explorer.

Transaction Economy

The following section discusses the transaction economy of the Duality Platform.

DYN Fee Structure: Transaction fees are the amount of tokens that a particular interaction with the blockchain costs. These are paid for in DYN. The fee amount for each different type of transaction is based on how much space it utilizes on the blockchain and the amount of work the nodes on the blockchain require to support the specialized record type. There are currently eighteen different transaction types that require a fee.

Public Transaction Description Deposit Transaction Fee Registration Fee/Month
Add New User Adds BDAP user entry to our public domain 1 0.001 0.01
Update User Updates BDAP user entry in our public domain 0 0.01 0.01
Remove User Removes BDAP user entry from our public domain 0 0.0001 0
Revoke User Revokes BDAP user entry from our public domain. Fluid command 0 10,000 0
Add New Group Adds BDAP group entry to our public domain 5 0.0001 0
Update Group Update a BDAP group entry in our public domain 0 0.0001 0.05
Remove Group Remove a BDAP group entry from our public domain 0 0.0001 0
Revoke Group Revoke a BDAP group entry from our public domain. Fluid command 0 25,000 0
Add Link Request Link request entry added to our public domain 0 0.01 0.001
Update Link Request Updates BDAP link request in our public domain 0 0.01 0
Delete Link Request Deletes BDAP link request from our public domain 0 0.0001 0
Accept Link Accepted link added to our public domain 0 0.01 0.0005
Update Accept Link Updates a BDAP link accept in our public domain 0 0.01 0
Delete Accept Link Deletes a BDAP link accept from our public domain 0 0.0001 0
Add New Certificate Adds BDAP certificate entry to our public domain 2 0.001 0.1
Update Certificate Updates BDAP certificate entry in our public domain 0 0.001 0.1
Remove Certificate Removes BDAP certificate entry from our public domain 0 0.0001 0
Revoke Certificate Revokes BDAP certificate entry from our public domain 0 25,000 0
Audit Record Creates an immutable audit record on the blockchain 0 0.0001 0

All DYN fees are burned out of supply when used. Burned fees are replaced with dynamically adjusted token emissions that are controlled with an on chain algorithm and with the Arbitrage Smart Contract. The burn and emission rates are made publicly available on-chain through the block explorer.

Platform Flow of Funds: The below graphic summarizes the anticipated flow of funds within the Duality ecosystem.


Section 08


The Dynamic blockchain includes a three-tier governance model to allow key functions to be easily changed without contentious hard forks or significant network upgrades.

Governance Tier 1 - Token Emission Adjustments

The Dynamic blockchain automatically adjusts DYN emissions through use of a novel Emission Algorithm (EA). The EA dynamically changes the Validator rewards using the burn rate from the previous 5,040 blocks (approximately every 7 days). This is different from existing protocols such as Bitcoin where the block rewards decrease over time and Validators rely on price appreciation. In the Dynamic ecosystem, Validators rely on increased rewards to offset the capped price of DYN.

The EA will enforce the below logic to maintain a healthy ecosystem:

  • Token emissions can never go below a baseline level, defined in table 1 above.
  • DYN emission rates will never increase to more than 50% of the total burn rate.
  • Emission rates can not be changed more than once per every 5,040 blocks (approximately 7 days).
  • The ratio between Miner and dynode rewards can’t be changed outside a range of 1.5 to 1.
Governance Tier 2 - KYC Nodes

The Dynode network will monitor KYC node performance to ensure that credentialing and certification are happening in a timely manner. Performance metrics will include response time, processing time, and availability. If it is determined that a KYC node is not meeting the minimum performance standards, the KYC node will be replaced by a selection from the Foundation. The Foundation’s board, upon receiving recommendations from the Dynode network, will be able to place KYC nodes that aren’t meeting their performance metrics under suspension. In order to use this feature there must first be a Dynode proposal, a Dynode quorum of at least 25% of all nodes from the KYC node’s region, and then a simple majority vote from that quorum. Because the KYC nodes play an important role in the integrity of the platform, the Dynode network, in combination with the Foundation's board, must be able to hold these nodes accountable to performance standards. Incumbents will be replaced by a selection from the Foundation. It is anticipated that major healthcare oversight and innovation organizations will assume the roles of the KYC nodes as the network matures.

Not all network participants are required to KYC - it will only be required if a particular user desires interactions with certain data sets, locations, or communication channels. Each data set and/or sidechain will have KYC parameters built in that will notify the potential user of the KYC requirements. The user can then choose to proceed with a KYC request or simply decide to move forward without the use of that information.

Governance Tier 3 - Dynodes and Foundation

Not unlike many protocols in existence today such as Cardano, Near, and Ethereum, Duality has a foundation that is dedicated to the long term support and success of the platform technologies with the ultimate goal of its users being the beneficiaries. The foundation has a board of directors with five members that oversees four areas of interest:

  • Change maximum block size: The ability to change the block size helps with network transaction speed. The ability to change this parameter is governed with the use of sovereign keys held by the board members, uses Fluid Protocol technology, and requires a majority vote. The number of times the block size can be changed is limited with an adjusting schedule starting at once per every 65,000 blocks and doubling at every interval beyond the first adjustment window.
  • Adjust the transaction fee schedule: The ability to change the transaction fee schedule is important as the application layer grows, new use case models are deployed, and as new transaction types are created. This parameter is governed with the use of sovereign keys held by the board members, uses Fluid Protocol technology, and requires a majority vote. The number of times the fee schedule can be changed is limited with an adjusting schedule starting at once per every 65,000 blocks and doubling at every interval beyond the first adjustment window.
  • Ban malicious wallets, accounts, certificates or applications: The Foundation, upon receiving recommendations from the Dynode network, will be able to place malicious wallets, accounts, certificates or applications under suspension. In order to use this feature there must first be a Dynode proposal, a Dynode quorum of at least 25% of all nodes, and then a simple majority vote from that quorum. Once the Dynodes have completed their vote, the board of directors from the Foundation will execute the required Fluid Protocol commands in order to carry out the results of the vote.

Section 09

Future State

A blockchain-based digital health platform has the potential to serve as a component of trusted, secure interoperability for an efficient healthcare ecosystem. The Duality platform is designed with open APIs and multiple language SDKs to help developers fast-track innovation using blockchain technology. Below is a list of suggested applications that can be built utilizing Duality’s blockchain identity and cross organizational connectivity services. This list is not meant to be exhaustive but rather to demonstrate future possibilities:

  • Distributed research network using de-identified or anonymous data with realtime cohort dataset access for authorized accounts
  • Globally discoverable healthcare provider directory
  • Cross organizational alert and real time communication systems
  • Evidence based referral system using the public provider directory
  • Disease surveillance system with bidirectional connections with state and federal health agency networks
  • Distributed Health Information Exchange
  • Provider Single-Sign-On (SSO)
  • Secure messaging applications for providers and patients using mobile and desktop devices
  • Create proof of visit and other audits that are tamper resistant and eventually immutable
  • Patient controlled data with the ability to view who, where, and when their record was accessed
  • Host distributed SQL and NoSQL databases used for private, permissioned data
  • Patient biometric identity services with the standard RESTful FHIR API specifications to plug into EHR systems to quickly augment the registration process, eliminate new duplicate records and facilitate record sharing with trusted external entities

Section 10


Providing a fully interoperable blockchain ecosystem to manage patient, provider, and healthcare data will ultimately aid in a smooth transition to a value-based healthcare delivery system. Using an interconnected network of public and private blockchains, Duality’s blockchain-based platform supports a wide range of innovative healthcare applications and unique interoperability solutions. Duality is open source, easily maintained, and does not rely on a single entity for development. We believe blockchain technology should remain open source to facilitate public security and reliability audits, and to push the industry towards patient-centered care. Our goal is to build an ecosystem democratizing healthcare innovation and to leverage blockchain technology to help make health care safer and more affordable for all.

Section 11


The information described in this paper is preliminary and subject to change at any time. Furthermore, this paper may contain forward-looking statements. Forward-looking statements generally relate to future events or our future performance. This includes, but is not limited to, Duality’s projected performance; the expected development of its business and projects; execution of its vision and growth strategy; and completion of projects that are currently underway, in development or otherwise under consideration. Forward-looking statements represent our management’s beliefs and assumptions only as of the date of this presentation. These statements are not a guarantee of future performance and undue reliance should not be placed on them. Such forward-looking statements necessarily involve known and unknown risks, which may cause actual performance and results in future periods to differ materially from any projections expressed or implied herein. Duality undertakes no obligation to update forward-looking statements. Although forward-looking statements are our best prediction at the time they are made, there can be no assurance that they will prove to be accurate, as actual results and future events could differ materially. The reader is cautioned not to place undue reliance on forward-looking statements.

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